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Ortho Hors D'oeuvres (Prompt):

Patient is a 33 year-old construction worker presenting with right ankle pain after a fall from scaffolding. On physical examination, his dorsalis pedis pulse is nonpalpable in the right foot; the pulse is also nondetectable via doppler. He has palpable posterior tibialis pulses bilaterally and his capillary refill is brisk. His sensation and ability to move his toes are intact.

Radiographs below:

Questions:

1) What is this patient's injury/fracture pattern?

2) What is the next step in evaluation?

3) What is the next step in management?

 
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